Runner's knee pain usually linked to foot, hip problem

Is running turning into a pain in the knees? It might actually be the hips that need your attention, according to a sports medicine expert at Baylor College of Medicine.

"The knees are usually the victims of the biomechanics that people run with," said Dr. Joseph Chorley, associate professor of pediatrics-adolescent and sports medicine at BCM and Texas Children's Hospital.

Common injury

When runners have knee pain, it's usually related to foot or hip problems. If a runner is not in control at the foot, ankle or hip, the knee is what gets twisted, has to overwork, and develops irritation.

"Knee pain is the most common injury in running, and the highest incidence for this pain occurs in new runners during their first one to two years of running," said Chorley, who has been one of the medical directors for the Houston Marathon since 1997.

Although anti-inflammatory medications, ice and bandages may be helpful, they may not address the underlying causes. Chorley makes the following suggestions:

Stretch properly before running

Don't increase mileage by more than 10 to 15 percent per week

Take a break and walk when knee pain begins

Replace shoes every six to nine months or every 500 miles

Know what your foot type is and be sure you have proper cushioning

However, there are some symptoms that may indicate a more severe problem:

Fluid accumulating in the knee

Painful popping or a mechanical sensation

Someone who had a previous structural injury such as torn ACL or PCL that's now experiencing pain

Anyone experiencing these symptoms should consult a sports medicine physician.

Strengthening exercises

Cross-training and strengthening exercises are also helpful for knee pain. Running three days a week and taking breaks between the days to do other exercises such as yoga and Pilates helps the body recover. These exercises also help strengthen the hips, which takes the stress off of the knees. Any exercises that help strengthen the core, glutes or hamstrings are helpful.

Chorley also suggests working on technique to help use the hips properly while running. One way to do this is to shorten the stride – make sure the foot does not hit the ground too far from the body. This makes it hard to keep momentum and makes it hard for the hip to maintain balance. It also causes a shock to the knee cap.

It's also important to maintain posture when fatigue sets in, Chorley said. Many people tend to run hunched over and bent at the hips when fatigued, which puts too much force on the hips and thus the knees.

Running with proper form

Taking a multi-vitamin can be helpful for runners, and fish oil is good for long distance runners.

"I think that everybody can be an athlete," said Chorley. "Part of being an athlete is finding what activity you're good at. Some people are born to run, and others have to work on their mechanics and endurance to make sure they are running with proper form."